System and method for combined photobiomodulation and electrical stimulation for epilepsy

Abstract

A multi-modal method of stimulation to provide therapy for an epilepsy patient. A neuroprotective therapy including both an electrical modulation signal and an optical modulation signal is generated on a periodic or scheduled basis. The patient is monitored, and if a trigger condition arises indicating one of potential seizure onset, seizure onset, or an ongoing seizure, a symptom modulation therapy is initiated. The neuroprotective therapy and the symptom modulation therapy may have different targets and other parameters.

What is claimed is: 
     
         1 . A method of treating a patient comprising:
 a) optically and electrically modulating a first neural target of the patient to provide neural protection to reduce progression of epilepsy;   b) identifying a triggering event indicating an elevated likelihood of actual or impending epilepsy seizure; and   c) in response to the identifying, electrically modulating a second neural target of the patient to mitigate effects of the epilepsy seizure.   
     
     
         2 . The method of  claim 1 , wherein step a) is performed using a cortical electrode positioned superficial to the brain; and step c) is performed using a deep brain stimulation electrode positioned inside the brain. 
     
     
         3 . The method of  claim 1 , wherein step a) is performed on a periodic basis, and steps b) and c) are performed only when a triggering event is identified. 
     
     
         4 . The method of  claim 1 , wherein electrical modulating in step a) is performed using two electrodes that are more than at least 2 cm apart, and step c) is performed using two electrodes that are less than one cm apart. 
     
     
         5 . The method of  claim 1 , wherein step a) is performed at a lower power density than step c). 
     
     
         6 . The method of  claim 1 , wherein step a) is performed with a lower output amplitude, duty cycle, pulse width, or frequency than step c). 
     
     
         7 . The method of  claim 1 , wherein step b) is performed by sensing electrical signals from the brain of the patient, analyzing the sensed electrical signals, and finding a divergence from a brain signal captured during an inter-ictal time period. 
     
     
         8 . The method of  claim 1 , wherein step c) is performed by:
 initiating electrical modulation of the second neural target;   analyzing the trigger condition and continuing the electrical modulation of the second neural target until the trigger condition ceases.   
     
     
         9 . The method of  claim 1 , wherein step c) is performed by:
 initiating electrical modulation of the second neural target;   continuing the electrical modulation of the second neural target until a stop-therapy condition arises.   
     
     
         10 . The method of  claim 9 , wherein the stop-therapy condition includes a patient indication that a seizure is not occurring. 
     
     
         11 . The method of  claim 9 , wherein the stop-therapy condition includes a timeout. 
     
     
         12 . The method of  claim 9 , wherein the stop-therapy condition includes a determination that the patient no longer shows an elevated likelihood of actual or impending epilepsy seizure. 
     
     
         13 . The method of  claim 1 , wherein step c) includes interrupting step a) and preventing step a) until step c) is completed. 
     
     
         14 . The method of  claim 1 , wherein the first target is associated with generation of malignant electrical signals that can lead to epilepsy seizure, and the second target is associated with transmission of the malignant electrical signals. 
     
     
         15 . The method of  claim 1 , wherein the first target is a seizure focus, and the second target is a part of the hippocampus. 
     
     
         16 . The method of  claim 1 , wherein the first target is on or in the cerebral cortex, and the second target is a part of the hippocampus. 
     
     
         17 . A system for treating a patient having a seizure condition comprising:
 a cortical lead adapted for positioning inside the skull of a patient and on the outside of the brain, the cortical lead including each of an electrode and an optical output device;   a deep brain stimulation lead adapted for positioning inside the brain of a patient near the hippocampus or near a seizure focal location;   a pulse generator coupled to each of the cortical lead and the deep brain stimulation lead, the pulse generator comprising a control circuitry, a sensing circuitry, and a pulse generator circuit, the control circuitry configured to:
 a) use the pulse generator circuit and the cortical lead to issue each of first optical outputs and first electrical outputs to modulate a first neural target of the patient to provide neural protection and reduce progression of epilepsy; 
 b) use the sensing circuitry for identifying a triggering event indicating an elevated likelihood of actual or impending epilepsy seizure; and 
 c) in response to the identifying, use the pulse generator circuit and the deep brain stimulation lead to issue second electrical outputs to modulate a second neural target of the patient to mitigate effects of the epilepsy seizure. 
   
     
     
         18 . The system of  claim 17 , wherein the control circuitry is also configured, in step c), to use the pulse generator circuit and the deep brain stimulation lead to issue second optical outputs to modulate the second neural target of the patient. 
     
     
         19 . The system of  claim 17 , wherein the first neural target includes a portion of the cerebral cortex. 
     
     
         20 . The system of  claim 17 , wherein the second neural target is the hippocampus.